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Pharmacists’ perceptions and acceptability of HIV self-testing in private pharmacies in Bamako, Mali: A mixed-methods
Samuel Kaboré Delwendé1, Juliette Tranchot-Diallo2, Alicia Christiana Koné1
1Université Nazi BONI, Bobo-Dioulasso, Burkina Faso.
Introduction:
HIV self-testing can expand access to screening, particularly among populations with limited connection to health services. In Mali, the role of private pharmacies remains understudied. This study examines pharmacists’ perceptions and client acceptability to inform the integration of HIV self-testing into private pharmacy settings.
Method:
This mixed-methods study was conducted in Bamako between February 7 and 28, 2022. Twelve pharmacists participated in semi-structured interviews, and 501 pharmacy clients completed a structured questionnaire. Qualitative data were analyzed using NVivo 14, while quantitative data were analyzed using SPSS and R. Multivariable logistic regression was used to identify factors associated with acceptability (defined as willingness to pay for an HIV self-test).
Results:
The mean age of participants was 31.6 years, and 67.1% were male. Most respondents did not know their HIV status (76.7%) and had never heard of HIV self-testing (91.6%).Overall, 62.1% of clients reported willingness to pay for an HIV self-test. In multivariable analysis, acceptability was independently associated with urban residence (aOR = 2.15; 95% CI: 1.28–3.61), university education (aOR = 3.28; 95% CI: 1.68–6.40), civil servant/student status (aOR = 2.52; 95% CI: 1.34–4.74), knowledge of one’s HIV status (aOR = 2.91; 95% CI: 1.18–7.18), prior awareness of HIVST (aOR = 4.22; 95% CI: 2.38–7.48), participation in HIV awareness sessions (aOR = 2.68; 95% CI: 1.42–5.06), recent HIV testing (aOR = 2.95; 95% CI: 1.55–5.61), and preference for both oral and blood-based tests (aOR = 1.85; 95% CI: 1.02–3.35) (all p < 0.05). Age, sex, perceived HIV risk, and knowledge of partner’s HIV status were not significantly associated with acceptability after adjustment. The mean acceptable price for an HIV self-test was 2,134 FCFA (~3.5 USD). Pharmacists perceived HIV self-testing as a confidential strategy that could facilitate early diagnosis, while highlighting challenges related to cost, availability, and limited public awareness.
Discussion:
Private pharmacies appear to be a relevant entry point for scaling up HIV self-testing in Mali. A phased implementation strategy including capacity building, targeted communication, and clear regulatory guidance is needed.